JP2001511388A - Device for reinforcing and / or correcting the spine, etc. - Google Patents

Device for reinforcing and / or correcting the spine, etc.

Info

Publication number
JP2001511388A
JP2001511388A JP2000504802A JP2000504802A JP2001511388A JP 2001511388 A JP2001511388 A JP 2001511388A JP 2000504802 A JP2000504802 A JP 2000504802A JP 2000504802 A JP2000504802 A JP 2000504802A JP 2001511388 A JP2001511388 A JP 2001511388A
Authority
JP
Japan
Prior art keywords
anchoring element
passage
spacer sleeve
anchoring
tensioning means
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Pending
Application number
JP2000504802A
Other languages
Japanese (ja)
Inventor
ハンス シュモーツェル
Original Assignee
プルス エンドプロシェティク アーゲー
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from DE19738968A external-priority patent/DE19738968B4/en
Application filed by プルス エンドプロシェティク アーゲー filed Critical プルス エンドプロシェティク アーゲー
Publication of JP2001511388A publication Critical patent/JP2001511388A/en
Pending legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7002—Longitudinal elements, e.g. rods
    • A61B17/7004—Longitudinal elements, e.g. rods with a cross-section which varies along its length
    • A61B17/7008—Longitudinal elements, e.g. rods with a cross-section which varies along its length with parts of, or attached to, the longitudinal elements, bearing against an outside of the screw or hook heads, e.g. nuts on threaded rods
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7002—Longitudinal elements, e.g. rods
    • A61B17/7011—Longitudinal element being non-straight, e.g. curved, angled or branched
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7002—Longitudinal elements, e.g. rods
    • A61B17/7019—Longitudinal elements having flexible parts, or parts connected together, such that after implantation the elements can move relative to each other
    • A61B17/702—Longitudinal elements having flexible parts, or parts connected together, such that after implantation the elements can move relative to each other having a core or insert, and a sleeve, whereby a screw or hook can move along the core or in the sleeve
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7032—Screws or hooks with U-shaped head or back through which longitudinal rods pass
    • A61B17/7034—Screws or hooks with U-shaped head or back through which longitudinal rods pass characterised by a lateral opening

Abstract

(57)【要約】 少なくとも２本の骨又は骨断片から成る骨格又は該骨格の一部分、あるいは少なくとも２本の椎骨から成る脊柱の一部分を補強及び／又は補正するための装置であって、連結要素のための少なくとも２つの繋留要素（１０）を有し、各繋留要素は骨又は椎骨に装着可能であり、前記連結要素は、繋留要素（１０）に固定することのできるケーブル、ワイヤ又はロッド状の引張手段（１５）と、引張手段（１５）に引張力がかけられたときに、隣接する繋留要素（１０）を所定の間隔に保つために、引張手段（１５）上を摺動可能なスペーサスリーブ（１６）とを含む装置。繋留要素（１０）の、スペーサスリーブ（１６）が当接する表面は、球面的に凸湾又は凹湾している。 (57) Abstract: A device for reinforcing and / or correcting a skeleton comprising at least two bones or bone fragments or a part of the skeleton, or a part of a spine comprising at least two vertebrae, comprising a connecting element. Has at least two anchoring elements (10), each anchoring element being attachable to a bone or a vertebra, said connecting element being a cable, wire or rod-like that can be fixed to the anchoring element (10) Slidable on the pulling means (15) to maintain adjacent anchoring elements (10) at a predetermined spacing when a pulling force is applied to the pulling means (15). An apparatus comprising a spacer sleeve (16). The surface of the anchoring element (10) on which the spacer sleeve (16) abuts is spherically convex or concave.

Description

【発明の詳細な説明】DETAILED DESCRIPTION OF THE INVENTION

【０００１】 本発明は、少なくとも２本の骨又は骨断片から成る骨格又は該骨格の一部分、
あるいは少なくとも２本の椎骨から成る脊柱の一部分を補強及び／又は補正する
ための装置であって、少なくとも２つの繋留要素を有し、各繋留要素は骨又は椎
骨に装着可能で連結要素を受容し、該連結要素は、繋留要素に装着可能なケーブ
ル、ワイヤ又はロッドからなる引張手段と、引張手段に引張力がかけられたとき
に、隣接する繋留要素間が所定の間隔に保たれるように前記引張手段上を摺動可
能なスペーサスリーブとを含む装置に関する。The present invention relates to a skeleton comprising at least two bones or bone fragments or a part of said skeleton,
Alternatively, a device for augmenting and / or correcting a portion of a spine comprising at least two vertebrae, comprising at least two anchoring elements, each anchoring element being attachable to a bone or vertebra and receiving a coupling element. The connecting element is provided with a pulling means comprising a cable, a wire or a rod which can be attached to the anchoring element, and such that when a tensile force is applied to the pulling means, a predetermined distance is maintained between adjacent anchoring elements. A spacer sleeve slidable on said pulling means.

【０００２】 この種の装置は、脊柱の一部分の補正に関連する国際特許出願公開ＷＯ９４／
１７７４５から公知である。この公知の装置は、長期間の機能信頼性と高い柔軟
性とを併せ持つことを特徴とする。この装置もまた、簡単な外科技術によって移
植可能であるとともに、その後の位置調整を可能にする。[0002] A device of this kind is disclosed in International Patent Application Publication No.
17745. This known device is characterized by having both long-term functional reliability and high flexibility. This device is also implantable by simple surgical techniques and allows for subsequent positioning.

【０００３】 本発明の目的は、公知の装置をその柔軟性に関して改良することである。[0003] It is an object of the present invention to improve known devices with respect to their flexibility.

【０００４】 上記の目的は、請求項１で与えられる特徴によって本発明により達成される。
請求項１の特徴に従えば、スペーサスリーブが当接する繋留要素の表面が、球状
に凸湾又は凹湾している。その結果、スペーサスリーブと係合する繋留要素への
スペーサスリーブの当接を、隣接する２つの繋留要素間の引張手段の方向に適合
するように、調整することができる。したがって、引張手段を繋留要素に関して
所定の角度で配置する必要が全くなくなる。その代わりに、使用者はスペーサス
リーブや該スペーサスリーブの繋留要素への当接に影響されることなく、上記角
度を個別に設定することができる。[0004] The above objective is accomplished by the present invention by the features provided in claim 1.
According to the features of claim 1, the surface of the anchoring element against which the spacer sleeve abuts is spherically convex or concave. As a result, the abutment of the spacer sleeve on the anchoring element engaging the spacer sleeve can be adjusted to match the direction of the tensioning means between two adjacent anchoring elements. Thus, there is no need to arrange the tensioning means at a predetermined angle with respect to the anchoring element. Instead, the user can individually set the angles without being influenced by the spacer sleeve or the abutment of the spacer sleeve on the anchoring element.

【０００５】 好ましくは、繋留要素に面する各スペーサスリーブの端面は、繋留要素の支持
面と相補的になるように形成されており、すなわち該端面は球状の凸部又は凹部
である。これにより、スペーサスリーブが繋留要素の支持面の凸状又は凹状湾曲
部に対して広い面積で当接することが可能になる。[0005] Preferably, the end face of each spacer sleeve facing the anchoring element is formed so as to be complementary to the support surface of the anchoring element, ie the end face is a spherical convex or concave part. This allows the spacer sleeve to abut a large area on the convex or concave curve of the support surface of the anchoring element.

【０００６】 本発明に従う装置の特に好ましい実施形態は、骨又は椎骨から突出する繋留要
素の頭部が球状であることを特徴とし、この場合の該繋留要素は、有茎ネジ又は
有茎フックのいずれかである。前者の場合、有茎ネジの頭部はボールヘッドであ
る。[0006] A particularly preferred embodiment of the device according to the invention is characterized in that the head of the anchoring element protruding from the bone or vertebra is spherical, wherein the anchoring element comprises a pedicle screw or a pedicle hook. Either. In the former case, the head of the pedicle screw is a ball head.

【０００７】 引張手段を繋留要素に固定できるようにするために、繋留要素又はその各頭部
は、円錐状又はトランペット形の外方に拡大する開口部を有する通路、特に穴を
含み、該開口部を介して引張手段が挿入又は退出される。その結果、引張手段は
、１５〜２５度の所定の立体角以内で、圧迫されずに繋留要素に進入し、該要素
から退出することができる。In order to be able to fix the tensioning means to the anchoring element, the anchoring element or each head thereof comprises a passage, in particular a hole, having a conically or trumpet-shaped outwardly expanding opening, said opening being provided. The pulling means is inserted or withdrawn via the part. As a result, the tensioning means can enter and leave the anchoring element without compression within a predetermined solid angle of 15 to 25 degrees.

【０００８】 １つの有益な実施形態において、通路又は穴は、溝穴を用いるか、あるいは開
放可能にするかのいずれかによって、その全長に亘って接近可能であるので、引
張手段を通路の長手方向に垂直な方向で該通路に挿入することができる。どちら
の実施形態においても、繋留要素はまず最初に係合される骨又は椎骨に固定する
ことができる。これを行った後にはじめて、引張手段がスペーサスリーブととも
に繋留要素に装着される。すなわち、本実施形態において、繋留要素を予め引張
手段に螺合させる必要がない。特に簡単な実施形態は最初に記載したものであり
、該実施形態では、繋留要素内の通路の全長に亘って、引張手段が導入される溝
穴が設けられている。あるいは、繋留要素は、該繋留要素内の溝穴が引張手段の
挿入のために全長に亘って開口することができるように、２つ又はそれ以上の部
品で構成される。その後、この通路上にその「蓋体」を戻し、それにより通路は
すべての側面上で径方向に閉じられる。[0008] In one advantageous embodiment, the passage means or holes are accessible along their entire length, either by using slots or by making them releasable, so that the tension means can be extended along the length of the passage. Can be inserted into the passage in a direction perpendicular to the direction. In either embodiment, the anchoring element can be secured to the bone or vertebra that is initially engaged. Only after this has been done is the tensioning means attached to the anchoring element together with the spacer sleeve. That is, in the present embodiment, it is not necessary to screw the anchoring element to the pulling means in advance. A particularly simple embodiment has been described at the outset, in which a slot is provided through which the tensioning means is introduced over the entire length of the passage in the anchoring element. Alternatively, the anchoring element is composed of two or more parts such that a slot in the anchoring element can be opened over its entire length for the insertion of a tensioning means. The "lid" is then returned over this passage, whereby the passage is radially closed on all sides.

【０００９】 スペーサスリーブ内の通路は、好ましくは、外方に円錐状又はトランペット形
に拡大する進入又は退出開口部を含み、その結果、スペーサスリーブがその係合
する繋留要素と当接する領域において、引張手段は、スペーサスリーブから繋留
要素を通る通路に、あるいはその逆方向に圧迫されずに移行することができる。The passage in the spacer sleeve preferably includes an outwardly conical or trumpet-shaped expanding entry or exit opening so that in the area where the spacer sleeve abuts its engaging anchoring element. The tensioning means can move without compression from the spacer sleeve into the passage through the anchoring element or vice versa.

【００１０】 本発明に従う装置の他の変形において、引張手段上に配置することのできる支
持ボール、特に長手方向に溝穴をつけた支持ボールをさらに設けることもでき、
前記各ボールは、同じ又は異なる長さの２つ又はそれ以上のスペーサスリーブを
並べて配置することにより、繋留要素間の距離が変えられるように、２つのスペ
ーサスリーブの間に挿入可能である。前記各支持ボールは、繋留要素内の通路に
相当する通路を含み、ケーブル、ワイヤ、又はロッド状の引張手段を受容する。
したがって、支持ボールは、それぞれ２つの隣接するスペーサスリーブ間の引張
手段に螺合される。In another variant of the device according to the invention, it is also possible to provide further a supporting ball, in particular a supporting ball with a longitudinal slot, which can be arranged on the pulling means,
Each said ball is insertable between two spacer sleeves such that the distance between the anchoring elements can be varied by arranging two or more spacer sleeves of the same or different lengths side by side. Each said support ball includes a passage corresponding to the passage in the anchoring element and receives a cable, wire or rod-like pulling means.
Thus, the support balls are each screwed into a pulling means between two adjacent spacer sleeves.

【００１１】 融通性をさらに高めるために、各繋留要素の引張手段を保持する部分、特にボ
ール頭部を有する有茎ネジのボール頭部を、該部分が引張手段の長手方向に垂直
な軸周り、あるいは有茎ネジの長軸周りに回転可能なように取り付けることも考
えられる。その結果、使用者には、個々の場合の要求に応じて、引張手段及びそ
れに係合するスペーサスリーブを三次元的に調整する機会が与えられる。In order to further increase the flexibility, the part holding the tension means of each anchoring element, in particular the ball head of a pedicle screw having a ball head, is pivoted about an axis perpendicular to the longitudinal direction of the tension means. Alternatively, it is also conceivable to attach the pedicle screw so as to be rotatable around the long axis. As a result, the user is given the opportunity to three-dimensionally adjust the tension means and the spacer sleeves which engage it, according to the requirements of the individual case.

【００１２】 以下に、本発明に従う装置の好ましい実施形態を添付の図面を参照して説明す
る。この唯一の図面は、繋留要素と、引張手段と、スペーサスリーブとの間の相
互作用を示すための断面図である。Hereinafter, preferred embodiments of the device according to the present invention will be described with reference to the accompanying drawings. This only drawing is a cross-sectional view to show the interaction between the anchoring element, the tensioning means and the spacer sleeve.

【００１３】 参照符号１０は、たとえば椎骨に螺合させることのできる有茎ネジの繋留部分
を示す。椎骨から突出する上記ネジの頭部１１は、球形である。ボール頭部１１
の上面は平坦にされている。この領域には六角形のソケット（図示せず）が設け
られており、該ソケットには、有茎ネジを椎骨に螺着するために相補的な工具を
挿入することができる。Reference numeral 10 indicates a tethered portion of a pedicle screw that can be screwed into a vertebra, for example. The head 11 of the screw protruding from the vertebra is spherical. Ball head 11
Is flattened. This area is provided with a hexagonal socket (not shown) into which a complementary tool can be inserted to screw pedicle screws to the vertebrae.

【００１４】 有茎ネジ１０の頭部１１は穴１２の形状の通路を含み、該穴１２は、頭部全体
に亘って通過し、各端部に外方に円錐状に拡大する入口又は出口開口部１３，１
４を有する。穴１２の内部には、ケーブル又はワイヤ状の引張手段１５が配置さ
れ、移植後、この引張手段１５に引張力が加えられる。スペーサスリーブ１６は
、ケーブル又はワイヤ状の引張手段１５に引張力が加えられたときに、隣接する
繋留要素が、本例では有茎ネジ１０が所定の距離だけ離れるように、引張手段１
５上に押し込まれる。スペーサスリーブ１６は、ネジ頭部１１の球状面に対して
圧接される。有茎ネジ１０のボール頭部１１に並置されるスペーサスリーブ１６
の端面１７は、球状支持面の形状と相補する形状を有する。すなわち端面１７は
球状に凹湾した形を有する。その結果、スペーサスリーブは、添付の図面におい
て双頭曲線矢印１８によって示される角度範囲内の、比較的広い領域に亘って、
有茎ネジ１０のボール頭部１１に当接する。The head 11 of the pedicle screw 10 includes a passage in the form of a hole 12 which passes through the entire head and expands outwardly and conically at each end. Opening 13,1
4 A cable or wire-like pulling means 15 is arranged inside the hole 12, and a pulling force is applied to the pulling means 15 after implantation. The spacer sleeve 16 is arranged so that, when a pulling force is applied to the cable or wire-like pulling means 15, the adjacent anchoring elements are such that the pedicle screw 10 in this example is separated by a predetermined distance.
5 is pushed on. The spacer sleeve 16 is pressed against the spherical surface of the screw head 11. Spacer sleeve 16 juxtaposed with ball head 11 of pedicle screw 10
Has a shape that is complementary to the shape of the spherical support surface. That is, the end face 17 has a spherical concave shape. As a result, the spacer sleeve extends over a relatively large area within the angular range indicated by the double-headed arrow 18 in the accompanying drawings.
It contacts the ball head 11 of the pedicle screw 10.

【００１５】 スペーサスリーブ１６が有茎ネジ１０のボール頭部１１に当接する角度は、ケ
ーブル又はワイヤ状の引張手段１５が、ボール頭部１１内の穴１２に進入、又は
該穴１２から退出するときの角度と一致する。引張手段の最大進入又は退出角度
は、入口又は出口開口部１３，１４の円錐構造によって特定される。The angle at which the spacer sleeve 16 abuts on the ball head 11 of the pedicle screw 10 is such that the cable or wire-like pulling means 15 enters or exits the hole 12 in the ball head 11. Coincides with the angle at the time. The maximum entry or exit angle of the pulling means is specified by the conical structure of the inlet or outlet openings 13,14.

【００１６】 スペーサスリーブ１６内の通路１９も同様に、円錐状又はトランペット形状で
外方に拡大する入口又は出口開口部２０を含み、これにより、スペーサスリーブ
１６がその係合する繋留要素に当接する場所、本例では有茎ネジ１０のボール頭
部１１に当接する場所において、ケーブル又はワイヤ状の引張手段１５が、圧迫
されずに、スペーサスリーブ１６から繋留要素を通って、本例では有茎ネジ１０
のボール頭部１１を通って通路１２に移行するか、あるいはその逆方向に移行す
ることができるようにする。この圧迫されない状態での移行は、添付の図面中に
明確に示されている。ここで示した有茎ネジ１０の代わりに、有茎フックもまた
繋留要素として使用することができる。The passage 19 in the spacer sleeve 16 likewise includes a conically or trumpet-shaped outwardly expanding inlet or outlet opening 20 so that the spacer sleeve 16 abuts its engaging anchoring element. At the location, in this example, where the ball head 11 of the pedicle screw 10 abuts, the cable or wire-like tensioning means 15 is not squeezed and passes through the anchoring element from the spacer sleeve 16 and, in this example, the pedicle Screw 10
To the passage 12 through the head 11 of the ball, or vice versa. This unstressed transition is clearly shown in the accompanying drawings. Instead of the pedicle screws 10 shown here, pedicle hooks can also be used as anchoring elements.

【００１７】 ボール頭部１１は、有茎ネジの長軸２１の周りに回転可能に取り付けることも
できる。これにより、使用者は引張手段及びスペーサスリーブの配向に関して、
さらに高い自由度を得ることができる。The ball head 11 can also be rotatably mounted around the long axis 21 of the pedicle screw. This allows the user to adjust the orientation of the tensioning means and the spacer sleeve.
A higher degree of freedom can be obtained.

【００１８】 支持ボールは、２つの隣接するスペーサスリーブ間に配置されるものである限
り、有茎ネジ１０のボール頭部１１の形状と同一の形状を有する。The support ball has the same shape as the shape of the ball head 11 of the pedicle screw 10 as long as it is located between two adjacent spacer sleeves.

【００１９】 ここに示した実施形態においては、ボール頭部１１は一部品で構成されており
、有茎ネジ１０の一体型部品である。移植に際しては、まずこのネジを椎骨に螺
合し、通路１２が正しく配向されるように位置決めを行う。次に、ケーブル又は
ワイヤ状の引張手段１５を通路にねじ込んだ後、スペーサスリーブ１６を引張手
段に押し込む。引張手段１５は、その一方の端部に厚み部分を有し、該厚み部分
は、補強すべき脊柱の部分の一方端部に配置された繋留要素の通路１２に当接す
る。また、引張手段１５は、その他方の端部にネジ部分を含み、このネジ部分に
引張ナットを螺合させることができる。このナットは、補強すべき脊柱の部分の
他方端部に配置された繋留要素に、直接的又は短いスペーサスリーブによって間
接的に当接する。In the embodiment shown here, the ball head 11 is made of one piece and is an integral part of the pedicle screw 10. During implantation, the screw is first screwed into the vertebra and positioned so that the passageway 12 is correctly oriented. Next, after the cable or wire-like tension means 15 is screwed into the passage, the spacer sleeve 16 is pushed into the tension means. The tensioning means 15 has at one end a thickened portion which abuts the passage 12 of the anchoring element arranged at one end of the portion of the spine to be reinforced. Further, the tensioning means 15 includes a threaded portion at the other end, and a tensioning nut can be screwed to the threaded portion. This nut rests directly or indirectly by means of a short spacer sleeve on an anchoring element located at the other end of the part of the spine to be reinforced.

【００２０】 引張手段１５としては、ネジ付ロッド、すなわち全長に亘って伸びる外部ネジ
を有するロッドを用いることもできる。この実施形態は、移植部位における要求
に応じて、ネジ付ロッドの長さを個々に調節することができるという利点を与え
る。As the pulling means 15, a threaded rod, that is, a rod having an external thread extending over the entire length can be used. This embodiment offers the advantage that the length of the threaded rod can be adjusted individually as required at the implantation site.

【００２１】 上述のように、繋留要素、ここでは有茎ネジ１０のボール頭部１１を通して通
路１２に引張手段をねじ込むことを避けるために、ボール頭部１１を２つの部分
で構成して、引張手段１５を挿入するために通路１２を開放可能にするか、ある
いはボール頭部１１に長手方向溝穴を形成して、該溝穴によって引張手段１５を
同様に通路１２に挿入できるようにしてもよい。本実施形態における引張手段１
５は、通路１２にある意味で掛止されている。As mentioned above, to avoid screwing the tensioning means into the passage 12 through the anchoring element, here the ball head 11 of the pedicle screw 10, the ball head 11 is made up of two parts, The passage 12 can be opened for inserting the means 15 or a longitudinal slot can be formed in the ball head 11 so that the pulling means 15 can likewise be inserted into the passage 12. Good. Tensile means 1 in this embodiment
5 is hung in the passage 12 in a sense.

【００２２】 すべての構成要素は、人体に適合しうる材料、特にチタン又はチタン合金から
製造される。特定の実施形態における引張手段１５は、可撓性ケーブル、特にロ
ープのように編まれたものとして構成することもできる。All components are manufactured from materials that are compatible with the human body, in particular titanium or titanium alloys. The tensioning means 15 in certain embodiments can also be configured as a flexible cable, especially a rope-like braid.

【００２３】 移植された状態において、上述のように、スペーサスリーブ１６を加圧下に置
きながら、引張力が引張手段１５に加えられる。In the implanted state, a tensile force is applied to the tensioning means 15 while placing the spacer sleeve 16 under pressure, as described above.

【００２４】 ここに記載した装置は、脊柱の一部分を補強及び／又は補正するためだけでな
く、特に外部固定装置又は髄内釘の一部として、一般的な骨格又は骨折を補強及
び／又は補正するのにも適している。しかしながら、上述の装置は、脊柱の一部
分を補正及び／又は補強するのに特に適している。The devices described herein may not only reinforce and / or correct a portion of the spine, but also reinforce and / or correct a common skeleton or fracture, particularly as part of an external fixation device or intramedullary nail. Also suitable for doing. However, the devices described above are particularly suitable for correcting and / or reinforcing a portion of the spine.

【００２５】 出願書類の中に開示したすべての特徴は、単独又は組合せにおいて、技術の現
状に対して新規である限り、本発明の必須要件として請求される。All features disclosed in the application, alone or in combination, are claimed as essential to the invention as long as they are new to the state of the art.

【図面の簡単な説明】[Brief description of the drawings]

【図１】 繋留要素と、引張手段と、スペーサスリーブとの間の相互作用を示すための断
面図である。FIG. 1 is a cross-sectional view to show the interaction between the anchoring element, the tensioning means and the spacer sleeve.

【符号の説明】[Explanation of symbols]

１０．．．有茎ネジ １１．．．ネジ頭 １２．．．穴 １３．．．入口開口部 １４．．．出口開口部 １５．．．引張手段 １６．．．スペーサスリーブ １７．．．端面 １８．．．双頭曲線矢印 １９．．．通路 ２０．．．入口又は出口開口部 ２１．．．有茎ネジの長軸 10. . . Pedicle screw 11. . . Screw head 12. . . Hole 13. . . Inlet opening 14. . . Outlet opening 15. . . Tensile means 16. . . Spacer sleeve 17. . . End face 18. . . Double headed arrow 19. . . Passage 20. . . Inlet or outlet opening 21. . . Long axis of pedicle screw

【手続補正書】特許協力条約第３４条補正の翻訳文提出書[Procedural Amendment] Submission of translation of Article 34 Amendment of the Patent Cooperation Treaty

【提出日】平成１２年１月３１日（２０００．１．３１）[Submission date] January 31, 2000 (2000.1.31)

【手続補正１】[Procedure amendment 1]

【補正対象書類名】明細書[Document name to be amended] Statement

【補正対象項目名】特許請求の範囲[Correction target item name] Claims

【補正方法】変更[Correction method] Change

【補正内容】[Correction contents]

【特許請求の範囲】[Claims]

【請求項９】 繋留要素の引張手段を繋留する部分、特にボールヘッド有茎
ネジ（１０）のボール頭部（１１）は、引張手段（１５）の長手範囲に垂直に延
びる軸周り、あるいは有茎ネジの長軸（２１）周りに回転可能なように装着され
ることを特徴とする請求項１ないし８のいずれか1項に記載の装置。9. The part of the anchoring element for anchoring the tensioning means, in particular the ball head (11) of the ball head pedicle screw (10), around an axis extending perpendicularly to the longitudinal extent of the tensioning means (15), or with a pivot. 9. The device according to claim 1, wherein the device is rotatably mounted around a long axis of the pedicle screw.

【手続補正書】[Procedure amendment]

【提出日】平成１３年２月１５日（２００１．２．１５）[Submission date] February 15, 2001 (2001.1.25)

【手続補正１】[Procedure amendment 1]

【補正対象書類名】明細書[Document name to be amended] Statement

【補正対象項目名】特許請求の範囲[Correction target item name] Claims

【補正方法】変更[Correction method] Change

【補正内容】[Correction contents]

【特許請求の範囲】[Claims]

───────────────────────────────────────────────────── フロントページの続き (81)指定国 ＥＰ(ＡＴ，ＢＥ，ＣＨ，ＣＹ， ＤＥ，ＤＫ，ＥＳ，ＦＩ，ＦＲ，ＧＢ，ＧＲ，ＩＥ，Ｉ Ｔ，ＬＵ，ＭＣ，ＮＬ，ＰＴ，ＳＥ)，ＪＰ，ＵＳ──────────────────────────────────────────────────続 き Continuation of front page (81) Designated country EP (AT, BE, CH, CY, DE, DK, ES, FI, FR, GB, GR, IE, IT, LU, MC, NL, PT, SE ), JP, US

Claims (11)

【特許請求の範囲】[Claims] 【請求項１】 少なくとも２本の骨又は骨断片から成る骨格又は該骨格の一
部分、あるいは少なくとも２本の椎骨から成る脊柱の一部分を補強及び／又は補
正するための装置であって、連結要素のための少なくとも２つの繋留要素（１０
）を有し、各繋留要素は骨又は椎骨に装着可能であり、前記連結要素は、繋留要
素（１０）に固定することのできるケーブル、ワイヤ又はロッド状の引張手段（
１５）と、引張手段（１５）に引張力がかけられたときに、隣接する繋留要素（
１０）を所定の間隔に保つために、引張手段（１５）上を摺動可能なスペーサス
リーブ（１６）とを含む装置において、 繋留要素（１０）の、スペーサスリーブ（１６）が当接する表面は、球面的に
凸湾又は凹湾していることを特徴とする装置。1. A device for reinforcing and / or correcting a skeleton comprising at least two bones or bone fragments or a part of said skeleton, or a part of a spine comprising at least two vertebrae, comprising: At least two anchoring elements (10
), Each anchoring element being attachable to a bone or vertebra, said coupling element being a cable, wire or rod-like tension means () which can be fixed to the anchoring element (10).
15) and, when a pulling force is applied to the pulling means (15), the adjacent anchoring element (
In order to keep 10) at a predetermined distance, in a device comprising a spacer sleeve (16) slidable on the tension means (15), the surface of the anchoring element (10) on which the spacer sleeve (16) abuts is A spherically convex or concave bay. 【請求項２】 各スペーサスリーブ（１６）の、繋留要素（１０）に向かう
端部の端面（１７）は、係合する繋留要素（１０）の支持面と相補的な形状、す
なわち球面的に凹湾又は凸湾した形状を有することを特徴とする請求項１に記載
の装置。2. The end face (17) of the end of each spacer sleeve (16) facing the anchoring element (10) has a shape complementary to the bearing surface of the engaging anchoring element (10), ie spherically. The device of claim 1, wherein the device has a concave or convex shape. 【請求項３】 骨又は椎骨から突出する繋留要素（１０）の頭部（１１）は
、球状であることを特徴とする請求項１又は２に記載の装置。3. The device according to claim 1, wherein the head of the anchoring element protruding from the bone or vertebra is spherical. 【請求項４】 繋留要素（１０）又はその頭部（１１）は、引張手段（１５
）のための通路、特に穴（１２）を含み、該穴（１２）は、全長に亘って通過し
、各端部には円錐状又はトランペット状に外方に拡大する入口又は出口開口部（
１３，１４）を有することを特徴とする請求項１ないし３のいずれか1項に記載 の装置。4. An anchoring element (10) or its head (11) is provided with tensioning means (15).
), In particular a hole (12), which passes through its entire length and at each end a conically or trumpet-shaped outwardly expanding inlet or outlet opening (
Device according to any of the preceding claims, characterized in that it comprises (13, 14). 【請求項５】 通路又は穴（１２）は、溝穴によって、あるいは開放可能に
することによって、その全長に亘って接近可能であり、その結果、引張手段（１
５）は通路又は穴（１２）に、該通路の長手方向に垂直な方向から挿入可能であ
ることを特徴とする請求項４に記載の装置。5. The passage or hole (12) is accessible over its entire length by a slot or by making it openable, so that the pulling means (1)
Device according to claim 4, characterized in that 5) is insertable into the passage or hole (12) from a direction perpendicular to the longitudinal direction of the passage. 【請求項６】 繋留要素、特に該繋留要素の頭部（１１）は、引張手段（１
５）のための通路又は穴（１２）の領域において分解可能に構成されることを特
徴とする請求項５に記載の装置。6. The anchoring element, in particular the head (11) of the anchoring element, comprises a tensioning means (1).
Device according to claim 5, characterized in that it is configured to be disassembled in the area of the passage or hole (12) for 5). 【請求項７】 スペーサスリーブ（１６）内の通路（１９）は、円錐状又は
トランペット形状で外方に拡大する入口又は出口開口部（２０）を含み、スペー
サスリーブ（１６）が係合する繋留要素、又は該繋留部分（１１）に当接する場
所において、引張手段（１５）が圧迫されずにスペーサスリーブ（１６）から繋
留要素（１０）を通る通路（１２）に移行するか、あるいはその逆方向に移行す
ることを特徴とする請求項１ないし６のいずれか1項に記載の装置。7. The passage (19) in the spacer sleeve (16) includes an outwardly expanding inlet or outlet opening (20) in the shape of a cone or trumpet, the tether with which the spacer sleeve (16) engages. Where the element or the abutment part (11) abuts, the tensioning means (15) transitions without compression from the spacer sleeve (16) to the passage (12) through the anchoring element (10) or vice versa. Apparatus according to any one of the preceding claims, wherein the apparatus moves in a direction. 【請求項８】 引張手段（１５）上に配置することのできる支持ボール、特
に溝穴をつけたボールを含み、各ボールは、同じ又は異なる長さの２つ又はそれ
以上のスペーサスリーブの列の組立てにより、離間距離を変更又は調整できるよ
うにするために、２つのスペーサスリーブ（１６）間に介在可能であることを特
徴とする請求項１ないし７のいずれか1項に記載の装置。8. Including a supporting ball, in particular a slotted ball, which can be arranged on the tensioning means (15), each ball being a row of two or more spacer sleeves of the same or different length. Device according to one of the preceding claims, characterized in that it can be interposed between two spacer sleeves (16) in order to be able to change or adjust the separation distance by assembling the device. 【請求項９】 繋留要素として、有茎フック又は有茎ネジ（１０）が使用さ
れることを特徴とする請求項１ないし８のいずれか1項に記載の装置。9. The device according to claim 1, wherein a pedicle hook or a pedicle screw is used as the anchoring element. 【請求項１０】 有茎ネジが繋留要素として機能する場合、ボールヘッドネ
ジが用いられ、該ネジのボール頭部（１１）には、該ネジの長軸（２１）に垂直
に延びる通路、特に引張手段（１５）のための穴（１２）が形成されることを特
徴とする請求項９に記載の装置。10. When the pedicle screw functions as an anchoring element, a ball head screw is used, and the ball head (11) of the screw has a passage extending perpendicular to the long axis (21) of the screw, in particular. Device according to claim 9, characterized in that a hole (12) for the tensioning means (15) is formed. 【請求項１１】 繋留要素の引張手段を繋留する部分、特にボールヘッド有
茎ネジ（１０）のボール頭部（１１）は、引張手段（１５）の長手範囲に垂直に
延びる軸周り、あるいは有茎ネジの長軸（２１）周りに回転可能なように装着さ
れることを特徴とする請求項１ないし１０のいずれか1項に記載の装置。11. The part of the anchoring element for anchoring the tensioning means, in particular the ball head (11) of the ball head pedicle screw (10), around an axis extending perpendicularly to the longitudinal extent of the tensioning means (15), or to the extent that it has The device according to any of the preceding claims, characterized in that it is mounted so as to be rotatable about the long axis (21) of the pedicle screw.
JP2000504802A 1997-07-31 1998-07-31 Device for reinforcing and / or correcting the spine, etc. Pending JP2001511388A (en)

Applications Claiming Priority (5)

Application Number Priority Date Filing Date Title
DE19733160 1997-07-31
DE19738968A DE19738968B4 (en) 1997-07-31 1997-09-05 Device for stiffening and / or correcting a spinal column or the like
DE19738968.6 1997-09-05
DE19733160.2 1997-09-05
PCT/EP1998/004812 WO1999005980A1 (en) 1997-07-31 1998-07-31 Device for stiffening and/or correcting a vertebral column or such like

Publications (1)

Publication Number Publication Date
JP2001511388A true JP2001511388A (en) 2001-08-14

Family

ID=26038756

Family Applications (1)

Application Number Title Priority Date Filing Date
JP2000504802A Pending JP2001511388A (en) 1997-07-31 1998-07-31 Device for reinforcing and / or correcting the spine, etc.

Country Status (4)

Country Link
US (1) US6290700B1 (en)
EP (1) EP0999795A1 (en)
JP (1) JP2001511388A (en)
WO (1) WO1999005980A1 (en)

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